| NPI | 1285195800 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: MN 68197) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 30038) |
| 207R00000X Internal Medicine (Licence: MN 68197) | |
| Enumeration Date | 2019-03-27 |
| Last Update Date | 2022-06-30 |